Genetic screening for cancer

Larbre34

I am interested in experiences or informed opinions in this area.

The history of bowel cancer in my family is very poor. My grandmother died at a young age from it (pre-modern techniques), her sister in mid-life. My mother and her only sibling have had two incidences of colo-rectal cancer each so far, at ages 46 and 69 for my mother and 39 and 62 for her sibling.

My mother is currently post-op on this most recent occurrence and it was a much larger tumour this time.

Now, because it is a topic for discussion in the family and among the doctors treating her, my siblings, cousins and I have been advised to increase our preventative measures. We are all in our 30s and some of us, including me, have had colonoscopies previously, all more than 5 years ago. We are being told the risks are 50/50 of developing the disease before we are 50, and one senior consultant suggested we go for genetic screening on the programme run by UCD/Crumlin.

My feeling is that the screening wont prevent anything and that we would need to watch for symptoms in any case. My cousin who is in the middle of an emigration visa process has been warned that if he is given formal warning of risk by genetic research that he must disclose it and it could harm his visa application as well as increase his health insurance premium by multiples. This of course applies to us all.

So, to screen or not to screen? Does screening really assist the potential sufferer or is more useful in the context of wider research? Are periodic colonoscopies a more practical option? Is health insurance compromised by failure to disclose a diagnosed genetic pre-disposition?

Discuss!

Condo131

Hi Larbre,
My mother died of Colon Cancer....many years ago. As a result, I have a colonoscopy every five years.

The Irish Cancer Society have an information booklet on Colorectal Cancer here. I figure you already know the contents at this stage, given what you and your family have/are going through.

[The download page for that booklet, along with many other forms of Cancer, is HERE.]

I'm certainly not up-to-speed with the issue of genetic testing, but was following the debate on the pros and cons a number of years ago. Insurance and disclosure of genetic test results was/is an issue. My understanding was, should a genetic test indicate a disposition to a(ny) particular condition, that disclosure was mandatory, or the Insurance Co could declare the contract null & void. I really don't know if that is the case now.

Wrt emigration, it seems to me that your cousin has an awful lot to think about. I suspect that some of your greater family group may opt for genetic testing anyway, and s/he could consider delaying their test until after they have emigrated, by which time the results for other family members would be available, making his/her decision whether to test, maybe, a little easier.

Given the family history it's looks like a good idea to have the test done. The upsides include a) The possibility of getting a result indicating that you are NOT likely to develop Cancer and b) If you are susceptible, then further screening/treatment can be carried out in a timely manner. The downsides are a) Should you be found to have a risk of developing Cancer, you have the worry of it developing....watching the kettle comes to mind.

Colonoscopies are really nothing to worry about, just two days hassle...drinking the concoction the day before (This is probably the worst bit)..... and the day itself being taken up between the test and being recommended not to do much/anything for the rest of the day.

I reckon you can direct your questions directly at the insurers involved, health, life etc. After all, you can hardly be penalised for asking "What are the effects, if any, of having a genetic test for (any particular form of) Cancer?" You've only asked a question, nothing more. If the answer is nothing, I'd recommend getting that in writing, even if it's only a printout of a website page.

Bottom line for anyone else reading this thread, look after your health - get yourself checked out regularly BUT be informed too! Ignorance may be bliss, but, in health terms, it can hurt you *VERY* badly.

Pretzill

We have a strong family history of colorectal cancer too - father, sibling, cousin, grandmother, and 3 uncles - we've all gone along the route of colonoscopy screening - and trying to follow a colon healthy diet too.

I think it's one of the more prevalent forms of cancer - but yes I would recommend colonoscopy because caught early it is treatable. And being screened can also put the mind at rest -

Larbre34

Thanks both, I appreciate your time.